According to the Centers for Disease Control and Prevention (CDC), more than 300,000 hip replacements are performed each year. “It's actually one of the surgeries that we do that has the best overall outcomes and success as far as patient happiness and patient's return to activity,” says Thad Dean, DO, orthopedic surgeon with Medical City Fort Worth.
Hip replacements are performed in patients who have damaged the ball and socket joint, and experience pain or limited activity despite other treatments. The most common cause of damage is osteoarthritis, which causes pain, swelling and limited motion in the joints. Individuals with hip injuries or conditions, like rheumatoid arthritis, may also be good candidates for a replacement.
The Procedure:
During the surgery, the damaged cartilage and bone from the hip is removed and replaced with man-made prostheses. The prostheses are typically made of metal, plastic and ceramic, based on the surgeon’s preference and how long the implants need to last. Hip replacement surgery is usually a one-time procedure for older patients, but younger patients may need more than one surgery. “Whenever [hip replacements are] done in younger patients, there's a possibility that the patient will outlive the implant,” says Dean.
During the one- to two-hour surgery, a six to twelve inch incision is made over the side of the hip, through the muscle. This is where the damaged cartilage and bone is removed and replaced with the prosthesis. Minimally invasive surgery, which is also used for hip replacements, requires smaller incisions and a shorter recovery period. Evidence suggests candidates that are younger than 50 years old, are relatively thin and lack bone and joint deformity, have the best success with mini-incision hip replacement surgery. Patients that are very muscular or have medical conditions that may slow the healing process may be riskier candidates for the minimally invasive surgery.
The Risks:
A hip replacement can relieve pain, improve walking and range of motion, and help the hip joint function more efficiently. Like any major surgery, hip replacements have some risks, such as infection and blood clots. “We treat folks with antibiotics to try to prevent infection, but it's probably the biggest risk that's associated with the surgery,” says Dean. Signs of infection include pain, redness and swelling of the joint and fever. Another potential problem following surgery is hip dislocation. Dislocation occurs when the man-made hip is smaller than the joint, making it vulnerable to popping out of the socket. Sometimes inflammation causes deterioration of bone, and blood clots. Some patients’ legs may also be slightly different lengths following their surgery.
The Recovery:
The rate of recovery and success of hip replacement surgery is determined by activity level, health, age, degree of joint deterioration and risk of infection. After surgery, patients should expect to spend a few days in the hospital and meet with a physical therapist.
Typically, patients can return to normal activity two or three months after their hip replacement surgery, but individuals with prosthetic hips are usually encouraged to avoid high-impact activity, like running and jumping.
